The Competing Discourses of Care at the End of Life

Candrian, Carey Brooke

Graduate Thesis Or Dissertation

The Competing Discourses of Care at the End of Life Public Deposited

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Citeable URL: https://scholar.colorado.edu/concern/graduate_thesis_or_dissertations/h415p965q

Abstract

This project details the nature of discourse and its consequences surrounding end of life care inside an emergency department and hospice. Detailing the way discourses organize meaning illustrates relationships between providers' language use and care practices. At both sites, providers struggle to manage the tension of providing humanistic care in settings that are inherently routine and regulated. In this project, providers' work practices transform to deal with this tension. As providers attempt to rehumanize care practices through language use, they ultimately tame death. Taming death allows providers to deal with the wildness and complexity of it but at the same time, taming death also tames and suppresses important conflicts and discussions from taking place. Even more, in taming death, meanings surrounding the culture of death became reproduced and naturalized thereby concealing them from critical engagement. Consequently, certain choices about how death should be handled and understood take priority over other choices and meanings that remain invisible or unspoken. Reopening choice and the way meaning around end of life is produced adds to current literature in several ways. The study contributes to theory and practice by (a) conceptualizing the everyday ways in which work practices and language influence end of life care, (b) detailing the role organizing processes play in the construction and organization of medical care around end of life, and (c) showing how reopening choice regarding meaning production is needed for education, policy, and practice.

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